The Morris Law Firm Blog

April 12, 2012

Texas Workers’ Compensation Income Benefits

When a Texas worker is injured in the course and scope of their employment (their employer must be a subscriber), there is an insurance policy that covers their injuries.  This insurance policy pays 100% of the medical care for necessary and reasonable medical care.  In addition, injured workers receive payments for disability and their impairments.

Types of Benefits:

Temporary Income Benefits:

Temporary Income Benefits (TIBs) are paid weekly to the injured worker prior to being placed at maximum medical improvement, when the worker is unable to earn the same income they received prior to the accident.  Temporary Income Benefits are generally paid at 70% of the pre-injury average weekly wage.  Make sure the amount includes any fringe benefits received from your employer.

Impairment Income Benefits:

Impairment Income Benefits (IIBs) are benefits you receive after you are found to be at maximum medical improvement.  When an injured worker is found to be at maximum medical improvement, they are also given an impairment rating from 0-100%.  For each point of impairment, the injured worker receives three weeks of Impairment Income Benefits.  The benefits are not for disability, they are paid even if the worker is working full time.

Supplemental Income Benefits:

Supplemental Income Benefits (SIBs) are paid to injured workers that receive an impairment rating of at least 15% and are not capable of returning to their previous type of employment.  Supplemental Income Benefits are paid monthly to injured workers who are completely unable to work, are actively engaged in seeking employment, are currently in a full time DARS approved program or are currently earning less than 80% of their pre-injury average weekly wage.

Lifetime Income Benefits:

Lifetime Income Benefits (LIBs) are generally paid weekly to injured workers who have an injury to their head that results in what the Division of Workers’ Compensation defines as incurable insanity or permanent imbecility.  Additionally, an injured worker may be entitled to Lifetime Income Benefits if they loss one of the following:

1)      The loss of use of both feet at or above the ankle;

2)      The loss of use of both hands at or above the wrist;

3)      The total loss of sight in both eyes; or

4)      Certain combinations of the above.

Death Benefits:

Death or Beneficiary Benefits are paid to dependents of a worker who dies as a result of the compensable injury.  This may be due to the results of the accident, treatment or medications taken for the effects of the accident.

Daniel L Morris, The Morris Law Firm, PLLC

(214)357-1782

info@themorrisfirm.net

September 15, 2011

Texas Workers’ Compensation Not Ready for Maximum Medical Improvement

Filed under: Workers' Compensation — Tags: , , , , , , — The Morris Law Firm 702 S. Beckley, Dallas, Texas, 75203 (214)357-1782 @ 9:55 pm

I know that most of the Texas Workers’ Compensation news seems to limit benefits and injured workers’ rights within the system.  However, once in a while a ray of light shines in and gives us a glimmer of hope.  One of these recent rays was provided by the Texas Workers’ Compensation Appeals Panel.

In Appeal No. 110670, the Division of Workers’ Compensation found that “it is impossible for a claimant to have reached MMI, since he has only had a minimal trial of post-operative care.”  In this case, the Appeals Panel overturned the findings of a designated doctor in finding maximum medical improvement, prior to the injured worker attending a pre-authorized chronic pain management program.  This allowed the injured worker to continue to receive Temporary Income Benefits (TIBs), while off work.

It is nice to see that in spite of all the forces trying to push injured workers out of the system prior to substantial recovery, there are still avenues for the injured worker to claim the statutory benefits for which his labor paid the insurance premiums.

June 29, 2011

Texas Workers’ Comp, Who is My Employer?

Filed under: Workers' Compensation — Tags: , , , , , , , , — The Morris Law Firm 702 S. Beckley, Dallas, Texas, 75203 (214)357-1782 @ 7:14 pm

Employment in the last 20 years has changed greatly.  In the past you finished school, found a job and then worked until you retired at the age of 65.  In today’s market, employees are laid off with every down turn of the economy.  Others have jobs where they are permanently employed through a temporary service or are called independent contractors.

When an injury occurs at work, who is your employer?  Most modern companies are actually a number of companies handling different aspects of the business.  The first thing to do is to look at your pay stub.  Most will have the name of the payer.  This is a good start on establishing the actual name of your employer.

The Texas Division of Workers’ Compensation defines employer as a person who makes a contract of hire, employs one or more employees, and has workers’ compensation insurance coverage.  However, when there are multiple potential employers, you may run into problems that some are subscribers to the Texas Workers’ Compensation system and some are not.  Finally, the law defines an independent contractor not just your employer calling you one.

Temporary Service:

Many workers are now employed by Temp Services.  If you work for a temp service, file the claim against them.  If you find out that they are a non-subscriber to Texas Workers’ Compensation (they have an alternative form of insurance), you can possibly file a claim against the company that the temp service sent you to.

When deciding which company is liable for your claim, the Division of Workers’ Compensation will look at who had the right of control over the employee’s activities.  The Borrowed Servant Doctrine is when you work for one employer, but get injured while under the control of another of another company.  This will allow you to receive benefits from the employer controlling your activities.

Independent Contractor:

In general an independent contractor is not an employee.  However, the determination is not made by the employer.  The Texas Division of Workers’ Compensation will determine if the employer had a right to control the details of the work performed.

To be considered an independent contractor, it must be shown that the person:

1)  acts as the employer of any employee of the contractor by paying wages, directing activities, and performing other similar functions characteristic of an employer-employee relationship;

2)  is free to determine the manner in which the work or service is performed, including the hours of labor of or method of payment to any employee;

3)  is required to furnish or to have employees, if any, furnish necessary tools, supplies, or materials to perform the work or service;  and

4)  possesses the skills required for the specific work or service.

The IW has the burden of proof to establish that he/she was an employee of the employer for purposes of the Act at the time the injury occurred.  However, you should always use an attorney familiar with workers’ compensation issues.  If you have any questions about your workers’ compensation contact, call the Dallas office of The Morris Law Firm at (214)357-1782 or via email at info@themorrisfirm.net.

August 4, 2010

Supplemental Income Benefits

Filed under: Workers' Compensation — Tags: , , , , — The Morris Law Firm 702 S. Beckley, Dallas, Texas, 75203 (214)357-1782 @ 9:26 pm

When it comes to the indemnity side of Workers’ Compensation, no area has had more changes than Supplemental Income Benefits (SIBs).  An injured workers is entitled to SIBs when they receive an Impairment Rating (IR) of 15% or greater, their disability is directly resulting from the compensable injury, they are earning less than 80% of their Average Weekly Wage (AWW) and demonstrated an active effort to obtain employment in accordance with Labor Code §408.1415.

When the Texas Law changed in 1991, claimants were found entitled to SIBs with a letter from a doctor stating that they can not work or a list of places where they look for work (seeking employment in good faith).

Presently entitlement to SIBs is determined under Texas Administrative Code §130.102

(1) An injured employee demonstrates an active effort to obtain employment by meeting at least one or any combination of the following work search requirements each week during the entire qualifying period:

(A) has returned to work in a position which is commensurate with the injured employee’s ability to work;

(B) has actively participated in a vocational rehabilitation program as defined in §130.101 of this title (relating to Definitions);

(C) has actively participated in work search efforts conducted through the Texas Workforce Commission (TWC);

(D) has performed active work search efforts documented by job applications; or

(E) has been unable to perform any type of work in any capacity, has provided a narrative report from a doctor which specifically explains how the injury causes a total inability to work, and no other records show that the injured employee is able to return to work.

Claimants must meet at least one of the criteria of A-E for each week of the qualifying period to be found eligible for the quarter of SIBs.  Training programs should be through the Department of Rehabilitative Serves (DARS) or have documentation that the program has been approved by DARS.

The Claimant should register with the Texas Workforce Commission (TWC) and if they are seeking employment, should have job contacts each week equal to or greater than the minimum number required by the TWC for the given county to qualify for unemployment benefits.

Under the new rules, a designated doctor can be requested for ability to work prior to the second anniversary of the initial determination for entitlement.   The designated doctor’s findings carry presumptive weight, but may be overcome by a preponderance of the evidence.

SIBs are a difficult area to navigate.  The application of the Rules are in constant flux and are evolving as new case law is decided.  If your insurance carrier disputes a quarter of SIBs and you prevail on that quarter, the insurance carrier is liable for your attorney’s fees.   There is no reason not to have an attorney on your side for SIBs.  Call us at our Dallas location, (214)357-1782 or contact us at info@themorrisfirm.net

Powered by WordPress